1. Corby, My Healthcare 4 June 2013

2. Welcome & Introduction NHS Corby CCG update Dr Peter Wilczynski, Chair

3. Housekeeping Please turn mobile phones to silent/off No fire alarm is planned, if you do hear the alarm, make your way to the fire exit

4. Aims of Today To keep you up-to-date with what’s happening in Corby To give you the opportunity to have your say on health services To build the relationships between the CCG and our local population

5. Waste Medicines Money down the drain Giles Owen, Prescribing Team

6. Waste Medicines Did you know that unused prescription medicines cost approximately £570,000 every year in Corby. Overall £300 million per year for the NHS.

7. Waste Medicines The NHS in Northamptonshire is running a campaign to raise everyone’s awareness of the problem of wasted medicines and its cost in both health terms and financial terms. From GP to prescription clerk, pharmacist to patient - we all have a role to play in reducing the problem

8. What do we mean by waste medicines? Unused or partially used prescription medicines Dispensed medicines which are sitting, uncollected, on the pharmacy/dispensary shelf or unused or partially used medicines in the patient’s home Medicines cannot be reused, even if they have never been opened Medicines returned from patients in this country are usually unsuitable for charitable donations to developing countries

9. What are the consequences of wasted medicine? Lost opportunities to improve the patient’s health and/or well-being: the doctor prescribed the medicine in the belief that it would relieve the patient’s symptoms and/or increase the patient’s quality and/or length of life Can be a safety risk to children and others who may accidentally take them Have to be disposed of safely by your local pharmacy or dispensing practice which costs an average of £1.36 per kg of medicines (In 2011-12 Northamptonshire spent £52,328 on the disposal of 38,493kg of waste)

10. So why do medicines become wasted? The patient recovers Side-effects or change in illness requires a change in prescription Patient gets admitted to hospital or dies The medicine was incorrectly supplied The “repeat prescription process” failed in some way e.g. a medicine was ordered when adequate supplies already existed Non-adherence to instructions – either intentional or accidental e.g. through misunderstanding Patients may worry about running out of medication and order too much Patients may not wish to tell the doctor they do not take the medication, in case this causes displeasure A medicine with a short shelf life may be issued in too large a quantity Patients may get medicines or appliances delivered and not get an opportunity to talk to anyone about excess supplies

11. What could this money buy? £570,000 a year in Corby could buy: 23 community nurses or 155 hip replacements or 38 breast cancer treatment courses or 570 Alzheimer’s drug treatment courses or cataract operations.

12. What could this money buy? Can we change this? Yes we can… It is estimated that 50% of medicines waste IS preventable.

13. How can WE change this ? Provide better support and education for patients, so that patients know what the medicines are for, why and how they should be taken Improve the repeat prescribing process so that the patient receives the right amount of the required medication The community pharmacist can provide services to patients to help them understand how their medicines should be taken and to feedback any problems to the doctor if necessary

14. How can YOU change this? Only order the medicines that you need If you get prescribed a medicine you are no longer using, please tell your doctor or pharmacist Check through your dispensed prescription medicines to make sure you have only received what you need

15. How can WE BOTH change this? Take better care of the vulnerable people in our community, particularly those who depend on others for the ordering and delivering of their medication

16. Waste Medicines Campaign 4 outreach events took place in Corby Willow Place and Castle Bingo We engaged with over 300 people Positive response building awareness of the costs and how people can help make changes

17. Waste Medicines Campaign Thank you Any Questions? Please see our display and take a leaflet www.manageyourmedicines.co.uk

18. What does your healthcare cost? Dr Joanne Watt

19. The cost of healthcare With limited budgets and resources, we all need to be mindful of our responsibilities to ensure the best use of NHS money The average cost of an appointment with your GP is £35, a nurse practitioner £20, and outpatient appointment to £110 Missed appointments account for 8.4% of all appointments In the last 12 months there were 5050 DNA appointments across Corby practices

20. The cost of healthcare There is still a cost if you do not attend your appointment Not attending appointments mean that we do not have sufficient notice to give appointments to others Attend every appointment your make or cancel it in good time

21. Interactive Session We are going to be using the vote pads, we will ask some questions and would like you to select which of the following you consider is the correct answer using the A, B, C, D buttons on your key pad.

22. Interactive Session Test Question: What is the capital of the UK? London Norwich Watford Corby A C B D

23. Interactive Session Select the correct answer A, B, C or D Select the button with the two way arrows to enter your answer B Your answer will appear in the display

24. On average, how much do you think the local NHS spends per person, per year? £400 £1,600 £8,200 £125 A C B D

25. How much do you think it costs the NHS for a patient to stay in a hospital overnight? £480 £710 £840 £250 A C B D

26. How much do you think it costs to carry out a minor ear operation (such as Grommets)? £400 £700 £1000 £200 A C B D

27. How much do you think it costs to carry out a cataract operation per eye? £202 £512 £748 £99 A C B D

28. How much do you think it costs to carry out a hip replacement operation? £3,856 £5,459 £9,568 £1,257 A C B D

29. How much do you think it costs the NHS to see you in the Accident and Emergency Department, even if you don’t need any treatment? £11 £38 £61 £0 A C B D

30. We want to hear about your health care experiences, whether good or bad. As part of our intelligence gathering, this information will be strictly confidential but used to help us improve the services in Corby Please talk to a healthcare professional or your Patient Participation Group if you have anything you want to share

31. Refreshments 15 minutes

32. Your Responsibility / Our Responsibility Nick Willmore

33. Shaping healthcare for Northamptonshire We are reviewing two of our services currently being delivered by Northamptonshire Healthcare NHS Foundation Trust to better shape our healthcare services to fit local needs Residential respite for people with neuro- degenerative conditions Community podiatry services

34. Respite care services Favell House in Northampton delivers an invaluable respite care service to patients with degenerative neurological conditions We propose to provide Personal Health Budgets to those needing residential respite care which will allow residents to choose where, and from whom, they receive the service. This will provide individuals with choice in making a decision about the most appropriate service to meet their needs We believe this will produce an enhanced service for the local population who currently use the service as well as for people who may need to use the service in the future

35. Community podiatry services Community podiatry services currently provide care for individuals in Northamptonshire from all risk levels Following assessment we propose to change the way that low, medium and high risk patients needing podiatric care are cared for so that future service provision is limited to patients with moderate and high clinical need Patients with low risk, for example patients with foot pain but no related underlying medical conditions, short courses for skin problems such as bunions and corns will have information about access to alternative service providers We believe this will produce a sustainable service for the local population who currently use the service as well as for people who may need to use the service in the future

36. Have your say We are keen to involve you, in the decisions we make about local health services Full consultation documents on these two areas are available on our website: www.corbyccg.nhs.uk/current- consultations www.corbyccg.nhs.uk/current- consultations Please take the time to read and provide your feedback via our online questionnaire: www.surveymonkey.com/s/respitenorthants www.surveymonkey.com/s/podiatrynorthants Copies are available to take away today

37. Pre-submitted Questions Dr Peter Wilczynski

38. Summary Dr Peter Wilczynski